Effect Of Serum Uric Acid Level On Blood Pressure And Renal Function After3Years Of Follow-up In Hypertensive Patients

ObjectivesThe aim of this study was to explore therelationship of baseline serum uric acidlevel with blood pressure control and estimated glomerular filtration rate (eGFR) inhypertensive patientsbased on a retrospective cohort study.MethodsThe subjects included an original cohort of1359patients with diagnosis ofessential hypertension from August2007to September2009and465cases who had areadmission after3years of follow-up in Fujian Provincial Hospital.Multipleregression analysis wasperformed to examine the effectof serum uric acid level onblood pressure control and renal function.Results1. Serum uric acid and blood pressure(1) Multiple regression analysis showed thatafter adjusting forantihypertensiontherapeutic intensity score, body mass index, serum lipid and renal function etc., each100μmol/L-higher uric acid at baseline was associated with a2.198mmHg [95%confidence interval(CI):0.254～4.141] increase in systolic blood pressure after3years of follow-up. In comparison with patients in the lowest quartile of baseline uricacid, patients in the highestquartile had a higher risk for poor blood pressurecontrol[odds ratio(OR)=2.349,95%CI:1.234～4.471].(2) Through3years of follow-up, the patients with decreased uric acid had lowersystolic blood pressure and higher control rate of blood pressure (all P<0.01). Bycontrast, the patients with increased uric acid had higher systolic blood pressure andlower control rate of blood pressure (all P<0.01). Multiple regression analysis showedthatafter adjusting foralteration ofantihypertension therapeutic intensity score,baseline blood pressure, the change of renal function etc., the elevated uric acid resulted in a higher risk forpoor systolic pressure control after3years of follow-up(OR=4.651,95%CI:2.877～7.520).2. Serum uric acid and renal function(1) Multiple regression analysis showed thatafteradjustingfor age, blood pressure,body mass index etc., each100μmol/L-higher uric acid at baseline was associatedwith a5.391ml/min/1.73m2(95%CI:-6.504～-4.277) decrease in eGFR.Incomparison with patients in the lowest quartile of baseline uric acid, patients in thehighest quartile had a higher risk for CKD (OR=7.288,95%CI:4.045～13.130).(2) The eGFR was lower in patients with increaseduricacid than that in patientswith decreased uric acid3years later (P<0.01) and there was no significant differencefrom baseline (P>0.05) between two groups. Multiple regression analysis showedthatafter adjusting foraging, alteration of blood pressure etc., increased uric acid3years later resulted in a higher risk forrenal function deterioration (OR=1.864,95%CI:1.199～2.900).Conclusions1. The control rate of blood pressure decreased with the elevationof uric acidlevel in hypertensive patients during3years of follow-up, suggestting that decreasinguric acid level may contribute to blood pressure control.2. The eGFR concentrations decreased morewith the elevation of uric acid levelin hypertensive patients during3years of follow-up, suggesting that decreasing uricacid level may contribute to delay the deterioration of renal function.